Monday, June 7, 2010

I think one of the biggest myths is that there are no effective treatments. Now we do have effective treatments, but they’re probably not as effective as people would like. They don’t cure the disease, but they do help temporarily. They can keep people out of the nursing home for a year or more and we’re finding that if we treat people very early that we can have an impact, so I think that’s probably one of the biggest myths I hear about.

Alzheimer's Reading Room

Question: What are some of the biggest myths surrounding Alzheimer’s?

Gary Small: I think one of the biggest myths is that there are no effective treatments. Now we do have effective treatments, but they’re probably not as effective as people would like. They don’t cure the disease, but they do help temporarily. They can keep people out of the nursing home for a year or more and we’re finding that if we treat people very early that we can have an impact, so I think that’s probably one of the biggest myths I hear about.

Question: What are some of the most promising studies you have done?

Gary Small: Probably one of the most gratifying studies I’ve been involved in has to do with detecting Alzheimer’s very early. It always made sense to me that the brain doesn’t all of the sudden get Alzheimer’s disease, that this is something that begins very gradually and is a process and in developing new brain scanning technologies we found that definitely to be the case, that we can see very subtle evidence of Alzheimer’s disease decades before people obviously have the disease. Now that often scares people because they think my God, I’m in my forties or fifties and I’ve got the inklings of Alzheimer’s, isn’t that terrible? I think it’s cause for hope because it means that we will in the future be able to detect people at risk and work to protect to a healthy brain rather than try to repair one once the damage sets in.

Question: What are the unique challenges in treating Alzheimer’s Disease?

Gary Small: Well you know I think a big challenge with Alzheimer’s disease is that it’s so subtle and gradual and so how do you differentiate it from normal aging?

We get this question all the time and it really comes down to the degree of the symptoms because all of us complain about memory slips. It’s very gradual an onset, but at some point we say you’ve got Alzheimer’s, you just don’t have normal aging and I think it’s a question of degree.

So that’s a big challenge, but I think in the research we’re doing that that may be something eventually that we aren’t so concerned about because I think that we’ll get to a stage where we’ll have brain scans and blood tests and we’ll do brain checks so we’ll deal with Alzheimer’s disease the way we deal with high cholesterol where you’ll have some kind of a marker that will tell you, you know you’re at high risk for Alzheimer’s so you should take this drug or vaccine and so in the future it will lower your risk in the future. So that would be great because it would de-stigmatize the problem. Right now a lot of people don’t come in until very late because they’re afraid of what they’re going to find out and I think it’s really something that probably will affect us all if we live long enough, so it’s important to try to deal with it now.

I mean if you look at the risk… If you look at the risk of Alzheimer’s disease it just keeps going up with age and if you follow the statistics, by age 110 we might all have it, so I don’t think that’s true because I think that lifestyle is very important. It’s not all biological or genetics, but there are probably thing we can do to improve our brain health and lower our future risk for Alzheimer’s.

GARY SMALL is a Professor of Psychiatry and Aging, UCLA School of MedicineBig Think

Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,510 articles with more than 8,000 links on the Internet. Bob resides in Delray Beach, FL.

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